Anicura Albano Animal Hospital, Rinkebyvägen 21, Danderyd, Sweden; Department of Clinical Sciences Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala, Sweden.
Department of Clinical Sciences Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala, Sweden.
J Vet Cardiol. 2022 Feb;39:89-101. doi: 10.1016/j.jvc.2021.12.005. Epub 2021 Dec 9.
Although challenging, predicting outcomes in dogs with myxomatous mitral valve disease (MMVD) is of importance to owners and veterinarians. Our aim was to compare the prognostic value of selected one-, two-, and three-dimensional and Doppler echocardiographic methods to predict cardiac-related and all-cause mortality in MMVD dogs. We hypothesize that three-dimensional methods would better predict prognosis than one- and two-dimensional methods.
One-hundred thirty-eight privately-owned dogs with MMVD.
Cox proportional Hazard analyses and Kaplan-Meier curves were used to investigate the predictive value of 14 variables; left atrial (LA) volume indexed to body weight (BW) measured by real-time three-dimensional echocardiography (RT3DE) and calculated using Simpson's modified method of discs (SMOD) and the area-length method; LA diameter in short-axis and long-axis to aortic in short-axis ratio, effective regurgitant orifice area indexed to body surface area measured in RT3DE en face view and calculated using four-chamber (4Ch) and two-chamber views alone or in combination; percentage increase in left ventricular end-diastolic and systolic internal diameters; fractional shortening; E wave velocity; regurgitant jet area/LA area.
All 14 variables were significantly predictive of cardiac-related mortality, and 11 were predictive of all-cause mortality. The prognosis was best predicted by LA volume/BW estimated by SMOD or RT3DE, consistently showing the highest predictive value in all analyses.
Left atrial volume calculated by SMOD showed a similar predictive value compared to RT3DE. Performing SMOD from apical 4Ch images should be considered an alternative to RT3DE for echocardiographic examinations where prognostication of disease outcome is sought.
尽管具有挑战性，但预测患有黏液瘤性二尖瓣疾病（MMVD）的犬的预后对主人和兽医都很重要。我们的目的是比较选定的一维、二维和三维及多普勒超声心动图方法在预测 MMVD 犬心脏相关和全因死亡率方面的预后价值。我们假设三维方法比一维和二维方法能更好地预测预后。
138 只患有 MMVD 的私人拥有的犬。
使用 Cox 比例风险分析和 Kaplan-Meier 曲线来研究 14 个变量的预测价值；实时三维超声心动图（RT3DE）测量并使用 Simpson 改良碟片法（SMOD）和面积长度法计算的左心房（LA）容积指数与体重（BW）；LA 在短轴和长轴的直径与短轴主动脉的比值，RT3DE 正面视图中测量的有效反流口面积指数与体表面积，并使用单独或组合的四腔（4Ch）和两腔视图计算；左心室舒张末期和收缩末期内径的百分比增加；分数缩短；E 波速度；反流射流面积/LA 面积。
所有 14 个变量均与心脏相关死亡率显著相关，11 个变量与全因死亡率相关。LA 容积/BW 由 SMOD 或 RT3DE 估计的预后最好，在所有分析中始终显示出最高的预测价值。
SMOD 计算的 LA 容积与 RT3DE 具有相似的预测价值。对于寻求预测疾病结果的超声心动图检查，应考虑从心尖 4Ch 图像进行 SMOD 作为 RT3DE 的替代方法。
